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Obstet Gynecol:孕激素和传统方案在美国大型队列中口服避孕药的有效性

2019-06-15 不详 网络

本研究旨在估计孕激素、无药丸间隔时间和体重指数不同的个体口服避孕药的实际有效性,同时关注半衰期长的孕激素和24天口服避孕药的疗效。一项大型,前瞻性,对照,非介入性长期队列研究纳入了52,218名美国参与者,对研究参与者进行主动监测,用于分析与口服避孕药相关的避孕失败。通过全面的后续程序确保低后续跟进。珍珠指数和生命表分析描述了避孕失败率。避孕失败的推论统计数据基于Cox回归模型。结果分析基于在暴露

本研究旨在估计孕激素、无药丸间隔时间和体重指数不同的个体口服避孕药的实际有效性,同时关注半衰期长的孕激素和24天口服避孕药的疗效。

一项大型,前瞻性,对照,非介入性长期队列研究纳入了52,218名美国参与者,对研究参与者进行主动监测,用于分析与口服避孕药相关的避孕失败。通过全面的后续程序确保低后续跟进。珍珠指数和生命表分析描述了避孕失败率。避孕失败的推论统计数据基于Cox回归模型。

结果分析基于在暴露口服避孕药73,269妇女年期间的1,634次意外怀孕。对于24天的屈螺酮和乙炔雌二醇方案以及其他孕激素的21天方案,避孕失败的生命表估计在第一个研究年后为2.1%和3.5%,第三年后为4.7%和6.7%。校正后的风险比为0.7(95%置信区间0.6-0.8)。分别对24天和21天的屈螺酮和炔诺酮治疗方案进行直接比较,结果显示24天治疗方案的避孕失败率较低。根据年龄,胎次和教育水平调整的避孕失败率随着体重指数的增加而略有增加。

综上所述,该研究结果表明,与传统的21天方案相比,含有半衰期长的孕激素的24天口服避孕药方案在常规医疗条件下显示出更高的避孕效果。肥胖似乎与避孕效果略有下降有关。

原始出处:

Dinger J, Minh TD, et al., Effectiveness of oral contraceptive pills in a large U.S. cohort comparing progestogen and regimen. Obstet Gynecol. 2011 Jan;117(1):33-40.


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